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Home My WebLink About16144-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No.. Z-17035 THIS CERTIFIES that the building ADDITION Location of Property 115 West Cove Road Cutchogue, N.Y. /t~d,s~ ~io: ....................... '~'tle~i ....................... h~l'~ County Tax Map No. 1000 Section I I 1 .Block 03 .... Lot 02 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated g u n e 1 7, 1 9 8 7 pursuant to which Building Permit No. 1 6 1 4/4 z dated ...J.u.n.e...2.9.,i,...1 9 8 .... 7 ........ . was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... DECK ~DDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR Thc certificate is issued to ALFONSE MARTINEZ-FONTS, JR. ..................... io¥.'o), '~g(~'~'~: ..................... of the aforesaid building. Suffolk County Department of Health Approva[ ........ g../? ............................... UNDERWRITERS CERTIFICATE NO .... ~/A PLUMBERS CERTIFICATION DATED: N/A Building Inspector Rev, 1/81 FOEM NO. ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y, BUILDIHG PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission is hereby granted to: ........ ./..~,~, ..~ ............................................. ....~.~..~....~o.:...,..,..~.~..~ ............ at prem,ses' located at ...J.l..~.....~....~......~.....~... ............. ..................................................................... County Tox Mop No. 1000 Section ....... !..L.(. ......... Block ..~..~ ........ Lot No......~...,~ .......... pursuant to application dated ...... ..~.,&,~,~....~J...~. ................... , 19..~..~.., and approved by the Building Inspector. Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted ~lmmm~m to the Building Inspec- tor with the following; for new buildings or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2.Final approval of Health Dept. of water supply and sewerage disposal--(S-9 form or equal). 3.Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building, 5.Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, buildings and unusual natural or topographic features. 2.Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees: Additions $25.00 POOLS $25.00 ALTERATION $25.00 1. Certificate of occupancy New Dwelling $25.00, Accessory ,$10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date .......................... NewCons truct±on ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property ....._ . .z~. ................................. House No. ~¢ ~e~et~ _ · H. ~mlet Owner or Owners of Property ~. ~.~..,~.,~ .~ - .~...~./~'~, .......... County Tax Map No. 1000 Section ............... Block ............... Lot ................ Subdivision ................................. Filed Map No ........... Lot No .............. Permit No ., . Date of Permit . cant .................................. Hea~th Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. Construction on above described building andp~rmit meets ~Jl app. li.~a~ble codes and regulations. ........... Rev. I0-10-7S UNDATION ~st) UNDATION 2nd) UGH FRAME & PLUMBING SULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: 765-~80Z BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] ~,.,.~ULATION FRAMING r~] FINAL REMARKS: · 'FORM NO. I '~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N,Y. 11971 TEL.: 765-180:3 Examined ..~..~.cl..., 19~ .~. ^pproved Permit Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS BOARD OF HEALTH-..~.- -. 3 SETS OF PLANS ~--'-- SURVEY .......... CHECK .......... SEPTIC FORM ............. NOTIFY CALL ...... ~.' 'fl .'w~' ' ' MAIL TO: ~ Date/-~...a!..og-. ...... 19 .c~../ a. This application must be completely filled~ by_typewriter or in ink and submitted to the Building Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule~ b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation. c. The work covered by this application may not be commenced befoie issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary in ctions. ~ ~ ";f' .... (Sign~ure of applic~haml*, 'f a o p ' (Mailing address of applicanCY/ State whether applicant is owner, lessee, agent, architecl, engineer, general contractor, electrician, plumber or builder. Name of owner of premises .~.~...~J .-~(a on. 7t~e~i~;d·) ......................... If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) . ; ALL CONTRACTOR'S I~UST BE SUFFOLK COUNTY LICENSED Builder's License No .... ... - ./~ .............. Other Trade's License No ...................... 1. Location of land on which prolapsed work will be done..; .......................... House Number //[ Street 3 Hamlet County Tax Map No. 1000 Section /..')~...~.Z//'~.~./..~/?B10ck .................. Lot a Subdivision . ~ .~~) ................ Filed Map No. ~.~ ........ Lot ..~ .......... 2. State existing use and occupancy of premises and intended nee and occupancy of proposed construction: a. ....... ...................................... b. Intended use and occupancy .......................................... ~. .......... . .....,,. · ' 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration Repair ........... Removal .............. Demolmon .............. Other Work ............. ,... ~>c~¢ ~ ~ ~. ~. ~ (Description) 4. Estimated Cost ............. ' ........................ red ...................................... ~ (to be paid on filing this application) 5. If dwelling, number of dwelling units ........ f.'. .... Number of dwelling units on each floor .... ~ ~ .......... If garage, number of cars .... ;.. ~ ............................................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use~ ..... ................ 7. Di~ mg~ng ~tmct ~r~s ~fany: Front .; .~ ...,,, .... Rear .............. Depth .............. ~ tg*~--~".',N ~ber of St~fies ..... ~ ........ ' ....... ~;'F' ~ ........... : -~ ........... io~~t ',,~jth alterations or additions: ~ .4 9.~ .... ff,~.~ Rear .~ ............. '-,8. ~[.,,onsof~?enew~`~~ ~[~"Hei~t~ . . ............ . ~/ , ...... ......... NumberofStofies~,z ...................... ctmn. Front &[...~. Rear .~.~ .......... ,,Depth .~.¢ .......... ~ma iber of Stofies~ ~ Rear .......... .~-~.~ ....................... / .~.b' ¢';...~ 't ............. 9. S~ , ..:~. .... ~ ...... ;:~,. .... :.; ......... Depth . .............. 10. Date of Purchase ............................. Ngme of Foyer.Owner ............................. 11. Zone or use district in which premises are situated... ~..f~ ................................. 12. Does proposed construction violate any zoning law, ordinance or regulation: ...... ~ ...................... 13. Will lot be regraded ........ ~ ....... ~ ........ Will excess, fill be removed f~m premises: Yes ~. 14. Nme of Owner of premises ~. ~~dress ~~.~.. Phone No. ~ Nme of Architect ....... ;. ~ ................ Address ................... Phone No ...... 1 .......... Nmne of Contractor .... ~ ................ Address .... : .............. Phone No ................ 15. Is th~s property locat~ w~th~n 300 feet of a t~.dal wetland? ~Yes ..... No ~; ~ ' *If yea, Southold To~ Trustees PermSt max be requSred. PLOT DIAG~M Locate clearly and distinctly al! buildings, whether existing or proposed, and. indicate ail set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW,~YORK, -. ~ ~ cOUNTY OF .)~.~... ~'~ ·, ~-...atr~. t4/. 2 .~......... . .-'P~. ............... being duly sworn, deposes and says that he is the applicant t~ (Name ofind!viduaI signing contract) above named. th~ i He is '. ................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this' application; that .all statements contained ~ this application are true to the'best of his knowledge and belief; and that the work: will be perfo~ed in the m~ner set forth ~ the application filed therewith. Sworn to before me this ~ .daY: ~ ...................... 0f.'2' . .......... 19...~n "' , ....... ........... on.t, / (Signature of applicant~ ~ ~eteof N~~